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Characteristics and Outcomes of Pediatric Patients With a Ventricular Assist Device Presenting to the Emergency Department
Conclusions Among subjects in a single outpatient pediatric VAD program presenting to the ED, the most common complaints were abdominal pain/vomiting, fever, and headache. The most common adverse events were major infection and right heart failure. Subjects had a high rate of ED utilization and hospital admission.
Source: Pediatric Emergency Care - February 1, 2022 Category: Emergency Medicine Tags: Original Research Article Source Type: research

Sudden Death in High School Athletes: A Case Series Examining the Influence of Sickle Cell Trait
We present a case series of fatal ECAST in high school athletes aged 14 to 16 years. All 3 athletes experienced collapse during practice sessions with muscle pain or weakness. Upon evaluation at the hospital, the athletes had a significant metabolic acidosis that did not respond as expected to fluid resuscitation. Admitting diagnoses for the athletes included exertional heat stroke or dehydration. All 3 athletes had profound rhabdomyolysis leading to acute renal failure, worsening metabolic acidosis, and hyperkalemia. They rapidly progressed to disseminated intravascular coagulation, multiorgan system failure, and death. T...
Source: Pediatric Emergency Care - February 1, 2022 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

European Resuscitation Council Guidelines 2021: First aid
The European Resuscitation Council has produced these first aid guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics include the first aid management of emergency medicine and trauma. For medical emergencies the following content is covered: recovery position, optimal positioning for shock, bronchodilator administration for asthma, recognition of stroke, early aspirin for chest pain, second dose of adrenaline for anaphylaxis, management of hypoglycaemia, oral rehydration solutions for treating exertion-related dehydration, manage...
Source: Resuscitation - March 24, 2021 Category: Emergency Medicine Authors: David A. Zideman, Eunice M. Singletary, Vere Borra, Pascal Cassan, Carmen D. Cimpoesu, Emmy De Buck, Therese Dj ärv, Anthony J. Handley, Barry Klaassen, Daniel Meyran, Emily Oliver, Kurtis Poole Source Type: research

Patient Care Falters as COVID-19 Devastates L.A. County (CA) Hospitals
Soumya Karlamangla, Rong-Gong Lin II, Luke Money Los Angeles Times (MCT) Los Angeles County’s healthcare system was buckling Wednesday under the unprecedented surge of COVID-19 patients, with bodies piling up at morgues and medical professionals resorting to increasingly desperate measures as they brace for conditions to worsen in the coming weeks. With hospitals overwhelmed by patients and no outlet valve available, doctors, nurses and paramedics are being forced to make wrenching choices about who gets care and at what level. “No one would believe this is in the United States,” ...
Source: JEMS Patient Care - December 31, 2020 Category: Emergency Medicine Authors: JEMS Staff Tags: Coronavirus News News Feed California EMS Hospital Paramedic Source Type: news

Diagnosis and management of acute aortic syndromes in the emergency department
AbstractAcute aortic syndromes (AASs) are deadly cardiovascular emergencies involving the thoracic aorta. AASs are relatively rare conditions, have unspecific signs and symptoms (including truncal pain, syncope, neurologic deficit and limb ischemia) and require contrast-enhanced tomography angiography (CTA) of the chest and abdomen for conclusive diagnosis and subsequent therapeutic planning. In the Emergency Department (ED), most patients with potential signs/symptoms of AASs are finally found affected by other alternative diagnoses. Hence, misdiagnosis and delayed diagnosis of AASs are major concerns. In critically ill p...
Source: Internal and Emergency Medicine - April 30, 2020 Category: Emergency Medicine Source Type: research

Improving the Care of Individuals With Sickle Cell Disease in the Emergency Department Using a Quality Improvement Framework: The Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS)
Sickle cell disease (SCD) is a severe chronic disease that leads to premature mortality caused by serious complications of the disease such as acute chest syndrome, stroke, and sepsis. Patients presenting to the emergency department (ED) with pain due to vaso-occlusive crisis (VOC) are at a higher risk for complications, making it imperative that emergency nurses, nurse practitioners, and physicians are knowledgeable about SCD and understand the other associated complications besides VOC. Because of the complexity of disease and misperceptions about SCD among ED nurses, physicians, and nurse practitioners, a quality improv...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

A Serious Diagnosis Lacking Common Symptoms
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Using Benchmark Data as a Launching Point for Quality Improvement in EMS
EMS agencies strive to provide the best possible care and contribute to positive patient outcomes. To ensure a high level of care, many agencies implement quality improvement programs; choosing a place to start for a quality improvement initiative, however, can seem overwhelming, with so many important conditions like cardiac arrest, sepsis, stroke, overdoses, etc. With limited time and resources, it’s necessary to concentrate efforts on measures that matter and are likely to make an impact. A great place to start with quality improvement efforts is where the gold standard is known and the frequency of events isn’t rar...
Source: JEMS Operations - February 20, 2019 Category: Emergency Medicine Authors: Remle Crowe, PhD, NREMT Tags: Exclusive Articles Operations Top Story Source Type: news

Clinical Performance Measures that Matter —Are You Ready?
Conclusion The future will belong to those who can prove value. The use of a clinical performance dashboard and comparisons to national data will help to ensure that when the payers come knocking on our doors looking for "proof" that what we do enhances patient care and improves patient outcome, we’ll have an answer! This is the first in a yearlong series of articles developed by the Academy of International Mobile Healthcare Integration (AIMHI).The AIMHI article series is developed in partnership with JEMS to help educate EMS agencies on the hallmarks and attributes of high-performance/high-value EMS system de...
Source: JEMS Special Topics - December 11, 2018 Category: Emergency Medicine Authors: Wayne C. Harbour, NRP Tags: Exclusive Articles Operations Administration and Leadership Source Type: news

Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

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